To address opioids, we need to think upstream

Prevention Institute statement on Trump administration declaration that the opioid epidemic is a public health emergency

Yesterday, President Trump declared the opioid epidemic a public health emergency. This provides critical recognition for what has long been clear to those living on the frontlines of the opioid epidemic, but the administration’s response so far is too small and narrow to meet the scale of the challenge we face. Fifty-seven thousand dollars in a Public Health Emergency Fund and increased ‘flexibility’ to shift much-needed funding away from other health priorities like HIV/AIDS, as could result from the administration’s order, will not even begin to address this crisis.

To address opioids, we need to significantly increase resources for treatment and also think upstream. That means addressing the sources of despair that can lead to substance misuse, addiction, overdose, and death in communities where hope and a sense of opportunity are slipping out of reach.

Addiction thrives when people and communities don’t. To address these underlying conditions of despair that drive substance misuse and addiction, we must fire up the engines of educational and economic opportunity. We need to invest in local economic development and job training; fund high-quality public education; and create opportunities for social reconnection. Communities need resources to rebuild overstretched healthcare systems, frayed social support networks, and underfunded cultural institutions. We must take on the structural factors -- entrenched inequalities of wealth and opportunity, social isolation, intergenerational trauma, racism, poverty, and the criminalization of substance misuse -- that shape the major health challenges of our times, from substance abuse, mental illness, and social disconnection to chronic disease and violence.

Only by addressing the underlying causes of the opioid epidemic – from declining community conditions and frayed social connections to dangerous and irresponsible pharmaceutical industry practices– can we get ahead of the opioid epidemic, prevent new waves of addiction and substance misuse, expand access to treatment for those who need it, and provide the resources that will empower all communities to thrive.

Fighting despair offers a key way to stop opioid abuse

In their op-ed in STAT, PI’s Manal Aboelata, Larry Cohen, and Sheila Savannah examine the rise of ‘deaths of despair,’ extolling the importance of looking at who profits from opioid abuse, how these substances flood into neighborhoods, and the factors that underlie the hopelessness, economic injustice, and disempowerment that drive people toward substance use.

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